Strategies in Pediatric Anesthesia Practice

Abstract

Hand-held computers and personal digital assistants (PDAs) are now commonplace and most trainees and a fair number of consultants have them, more often using them as electronic personal organizers, but also as log-books and reference sources. Some users of PDAs may already be using them for reference with programs such as Epocrates, an electronic formulary from America. This American website is another source of reference software for medical specialities, although Strategies in Pediatric Anesthesia Practice is the only one that is solely related to anaesthesia. All of the software on this website has been specifically written for hand-held computers, and therefore should not be regarded as books that have been ported to hand-held devices. The web page lists available software in alphabetical order for both the Palm operating system and the Pocket PC (but not Psion). Clicking on the software link for Strategies in Pediatric Anesthesia Practice for the Palm takes you to a page that gives a six-line description of the software and some basic information, such as price ($50.00), minimum version of the operating system required (version 3.0 or above), editor (Ron Litman from the Children's Hospital of Philadelphia, USA), and that it is available for electronic download. It is possible to try a ‘demo’ or purchase the full version by ‘adding to cart’. Payment is by credit card only and the purchaser is sent an activation code by email. The demo version only allows 15 uses of the software before it is disabled. The size of the file that is downloaded depends on which version of the software is needed; for the Palm operating system it is 1.6 Mb, and for the Pocket PC it is 2.86 Mb. Once on the PC, clicking on the file opens the software, giving simple instructions for installing the program on the PDA. This will happen at the next ‘Hotsync’ (when the PDA is synchronized with the PC), and uses 280 kb of Palm memory. However, two sequential hotsyncs seem to be required to fully install the product. On a Palm, the program is installed as SPA2003 in its own category, Pocketmedicine, and does support colour. The main index and the topics section of the table of contents are a list of conditions that require surgery (and hence anaesthesia) in alphabetical order. There is a search tool (a binoculars icon), which allows the user to look for words or parts of words in the titles of the conditions. This is particularly useful as some of the phrasing of the surgical conditions does differ on this side of the Atlantic Ocean. There are a large number of paediatric conditions listed, ranging from circumcision to heart transplantation. Each condition is made up of seven screens, which can be accessed by a drop down menu or seven short-cuts listed on the right of the screen. The short-cuts can be personalized, although I encountered some problems with this facility on the version I tested. The first screen lists coexisting diseases, the second preoperative assessment, followed by procedural considerations, anaesthetic plan, pain management, postoperative plan, and finally the list of authors of the relevant section. Each section is made up of bullet points and is quite easy to follow. However, there is no glossary and hence some of the North American abbreviations and acronyms are not easy to follow, particularly in the preoperative assessment sections, for instance ‘lytes’ is obviously electrolytes, but ‘H/H’? (I think it stands for haemoglobin and haematocrit, but I could be wrong.) Users can add new topics with key points for future reference, and each condition also has a section to add personal notes. There are arrow navigation icons for going back a screen, and also a history screen that shows which conditions have been accessed. Whilst I was using this software I kept on wondering, who is it aimed at? It is certainly easy to use and is informative, but not enough detail or explanation (there are no illustrations) is given for a trainee to learn all about the conditions. To get the most out of this software, some previous knowledge is necessary. However, whilst it is unlikely that I will urgently need to look up the anaesthetic management of some of the procedures listed, for example, a Fontan procedure, I may need to know what it is (under coexisting diseases), and some of the problems that these patients encounter (under postoperative), which is useful. But is it worth $50.00? Try the demo and judge for yourself.